Study: Medicare's toll-free help line is often inaccurate

Test shows 3 of 10 answers are wrong

December 12, 2004|By Robert Pear, New York Times News Service.

WASHINGTON — Medicare's toll-free telephone line, one of the main vehicles for disseminating information about new prescription drug benefits and drug discount cards, gives accurate answers less than two-thirds of the time, congressional investigators say.

In a test of the service, investigators from the Government Accountability Office found that 29 percent of callers received inaccurate answers, while 10 percent received no answers.

Use of the phone line is expected to soar in coming months as the elderly sort through a complex array of new insurance options and benefits.

Discount cards, available since May, can significantly reduce drug costs. But many beneficiaries hesitated to sign up, saying they were puzzled by the multiplicity of options. A government Web site compares drug prices under various cards, but many beneficiaries say they are not adept at using computers and find the site difficult to navigate.

In response, Bush administration officials say that beneficiaries can receive all the information they need by calling 800-MEDICARE (800-633-4227). But the people who answer those calls are themselves often confused, the Government Accountability Office said, in an evaluation required by Congress under the new law.

"We found that 6 out of 10 calls were answered accurately, 3 out of 10 calls were answered inaccurately and we were not able to get a response for 1 out of 10 calls," the report stated.

In another recent report, the accountability office found that Medicare provided even less accurate information to doctors who inquired about the proper way to bill for treating Medicare patients.

In response to 300 test calls, the GAO said, customer service representatives gave correct and complete responses to only 4 percent of the billing questions. About 54 percent of the answers were simply wrong, and 42 percent were incomplete or partly correct, it said.

The toll-free number for beneficiaries received 16.5 million calls in the fiscal year that ended Sept. 30, up from 5.6 million in the previous year.

Federal officials encouraged people to call but now cite the deluge of calls to explain why they were unable to give accurate answers.

"We were faced with an unprecedented volume of calls about a new part of the Medicare program that required new training efforts and many new customer service representatives," said Dr. Mark McClellan, administrator of the Centers for Medicare and Medicaid Services. "We believe we responded as well as we reasonably could given the unique and demanding circumstances."

Employees of the accountability office placed 420 calls to the toll-free line. They posed six questions of the type commonly asked by beneficiaries. Each was asked 70 times.

Medicare officials prepare scripts to answer questions about the program, which provides health insurance to 41 million elderly and disabled people. But federal investigators found that the telephone operators "did not seem to know enough" to choose the right script or did not understand it.

Beneficiaries can obtain a credit of $600 a year with their discount cards if their incomes do not exceed certain levels ($12,569 for an individual). Callers who asked about the assistance received wrong answers 79 percent of the time. Many operators did not realize they had to consider the source of income, as well as the amount. Social Security benefits are counted as income, for example, but life insurance benefits are not.